Division of Cardiology/Electrophysiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Pacing Clin Electrophysiol. 2020 Apr;43(4):360-363. doi: 10.1111/pace.13879. Epub 2020 Feb 17.
A 64-year-old man underwent implantation of a permanent His-bundle pacemaker. A marked rise in the selective His-bundle capture threshold was noted 1 month after the patient started flecainide acetate for rhythm control of recurrent, symptomatic atrial flutter and atrial fibrillation. The capture threshold subsequently normalized 4 days after discontinuing flecainide and switching to dofetilide. To our knowledge, this is the first documented case of a rise in selective His-bundle capture threshold associated with flecainide acetate. Further studies are needed to characterize this association which could result in higher capture thresholds, decreased battery longevity, and mimic His-bundle lead failure.
一位 64 岁男性因反复发作、有症状的心房扑动和心房颤动行节律控制而接受永久性希氏束起搏器植入。患者开始服用氟卡尼醋酸盐 1 个月后，选择性希氏束夺获阈值明显升高。停用氟卡尼并换用多非利特 4 天后，夺获阈值随后恢复正常。据我们所知，这是首例与氟卡尼醋酸盐相关的选择性希氏束夺获阈值升高的记录病例。需要进一步的研究来描述这种关联，这可能导致更高的夺获阈值、降低电池寿命，并模拟希氏束导联故障。
